Shana Lieberman Klinger, M.A., and Scott White
The New York State Nursing Home Health Information Technology (HIT) Demonstration Project is a publicly subsidized initiative to implement comprehensive, point-of-care electronic medical records in 20 New York City nursing homes. Because of an innovative union–employer partnership, direct-care staff of the homes were heavily involved in the planning process. Union employees were assured upfront that no layoffs would result from HIT implementation, and training was a high priority in vendor selection. All participating homes successfully replaced paper records with electronic ones, and, after the intensive pre-implementation planning period, it took less than six months on average for facilities to make this transition. Despite this shared success, variation existed between homes regarding: 1) organizational aims for adapting HIT; 2) the technology’s perceived or real effects; and 3) implementation of quality improvement efforts as a result of newly available data.
This study was based on publicly available information and self-reported data provided by the case study institution(s). The aim of Commonwealth Fund–sponsored case studies of this type is to identify institutions that have achieved results indicating high performance in a particular area of interest, have undertaken innovations designed to reach higher performance, or exemplify attributes that can foster high performance. The studies are intended to enable other institutions to draw lessons from the studied institutions' experience that will be helpful in their own efforts to become high performers. Even the best-performing organizations may fall short in some areas or make mistakes—emphasizing the need for systematic approaches to improve quality and prevent harm to patients and staff. The Commonwealth Fund is not an accreditor of health care organizations or systems, and the inclusion of an institution in the Fund's case study series is not an endorsement by the Fund for receipt of health care from the institution.